Role of vitamin B3 in the prevention of acute kidney injury post-cardiac surgery through measurement of serum Cystatin C and Creatinine

Main Article Content

Wallaa Luay Alfalluji
Ghazwan Talal Mahdi
Ahmed Ammar
Mohammed Shuailah
Mayssa Jalal Majeed

Keywords

vitamin, kidney, role, measurement.

Abstract

Background—Acute kidney injury is a risk factor for mortality in cardiac surgery patients. Nicotinamide adenine dinucleotide (NAD+) is a cofactor for numerous enzymes involved in cellular energy metabolism, and for adaptive responses of cells to bioenergetics and oxidative stress and is now a major player in aging and age-related diseases. Plasma cystatin C and creatinine have an important role in the early diagnosis of renal injury post-cardiac surgery.
Method: Using cohort - study design based on 90 subjects all patients subjected to open-heart surgery, were divided into two groups according to the dosing of niacin (vitamin B3) we measured serum cystatin C and creatinine basal level, one day before surgery, one day after surgery and after 7 days after surgery.
Results: Serum cystatin C level and creatinine significantly elevated (p≤0.05) in the second group (control group) (subjects who didn´t receive vitamin B3 supplement from baseline while those who receive vitamin B3 supplement show stable serum cystatin C and creatinine level.
Conclusion: vitamin B3 (niacin) has a beneficial role in renal protection after cardiac surgery.

Abstract 386 | pdf Downloads 192

References

1. Bove T, Monaco F, Covello RD, Zangrillo A. Acute renal failure and cardiac surgery. HSR Proc Intensive Care Cardiovasc Anesth. 2009;1(3):13.
2. Wang Y, Bellomo R. Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nat Rev Nephrol. 2017;13(11):697.
3. Ng KP, Moody WE, Chue CD, Edwards NC, Savage T, Tomson CR V, et al. Central pulse pressure in patients with chronic kidney disease and
in renal transplant recipients. J Hum Hypertens. 2014;28(3):180–5.
4. Åkerblom A, Helmersson-Karlqvist J, Flodin M, Larsson A. Comparison between Cystatin C-and Creatinine-Estimated Glomerular Filtration Rate in Cardiology Patients. Cardiorenal Med. 2015;5(4):289–96.
5. Zarbock A, Schmidt C, Van Aken H, Wempe C, Martens S, Zahn PK, et al. Effect of remote ischemic preconditioning on kidney injury among
high-risk patients undergoing cardiac surgery: a randomized clinical trial. Jama. 2015;313(21):2133–41.
6. Nayak NK, Khedkar CC, Khedkar GD, KhedkarCD. Osteoporosis. Encyclopedia of food and health. Oxford: Academic Press; 2016.
7. Nikiforov A, Kulikova V, Ziegler M. The human NAD metabolome: Functions, metabolism and compartmentalization. Crit Rev Biochem Mol Biol. 2015;50(4):284–97.
8. Villa P, Jiménez M, Soriano M-C, Manzanares J, Casasnovas P. Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients. Crit Care. 2005;9(2):1–5.
9. Zi M, Xu Y. Involvement of cystatin C in immunity and apoptosis. Immunol Lett. 2018;196:80–90.
10. Nilsson-Ehle P, Grubb A. New markers for the determination of GFR: iohexol clearance and cystatin C serum concentration. Kidney Int Suppl. 1994;47:S17-9.
11. Pergande M, Jung K. Sandwich enzyme immunoassay of cystatin C in serum with commercially available antibodies. Clin Chem.
1993;39(9):1885–90.
12. Herget-Rosenthal S, Trabold S, Pietruck F, Holtmann M, Philipp T, Kribben A. Cystatin C: efficacy as screening test for reduced glomerular
filtration rate. Am J Nephrol. 2000;20(2):97–102.
13. Finney H, Newman DJ, Price CP. Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance. Ann Clin Biochem. 2000;37(1):49–59.
14. Schiffl H. Gender differences in the susceptibility of hospital-acquiredacute kidney injury: more questions than answers. Int
Urol Nephrol. 2020;1–4.
15. Forbes JM. Mitochondria–power players in kidney function? Trends Endocrinol Metab.
2016;27(7):441–2.
16. Tran MT, Zsengeller ZK, Berg AH, Khankin E V, Bhasin MK, Kim W, et al. PGC1α drives NAD biosynthesis linking oxidative metabolism to renal protection. Nature. 2016;531(7595):528–32.
17. Cantó C, Menzies KJ, Auwerx J. NAD+ metabolism and the control of energy homeostasis: a balancing act between mitochondria and the
nucleus. Cell Metab. 2015;22(1):31–53.
18. He W, Newman JC, Wang MZ, Ho L, Verdin E. Mitochondrial sirtuins: regulators of protein acylation and metabolism. Trends Endocrinol
Metab. 2012;23(9):467–76.
19. Ebru AE, Kilic A, Korkmaz FS, Seker R, Sasmaz H, Demirtas S, et al. Is cystatin-C superior to creatinine in the early diagnosis of contrast-induced nephropathy?: a potential new biomarker for an old complication. J Postgrad Med. 2014;60(2):135.
20. Spahillari A, Parikh CR, Sint K, Koyner JL, Patel UD, Edelstein CL, et al. Serum cystatin C–versus creatinine-based definitions of acute kidney injury following cardiac surgery: a prospective cohort study. Am J Kidney Dis. 2012;60(6):922–9.
21. Morgan IS, Codispoti M, Sanger K, Mankad PS. Superiority of centrifugal pump over roller pump in paediatric cardiac surgery: prospective randomised trial. Eur J cardio-thoracic Surg. 1998;13(5):526–32.
22. Wright G. Haemolysis during cardiopulmonary bypass: update. Perfusion. 2001;16(5):345–51.
23. Baliga R, Ueda N, Walker PD, Shah S V. Oxidant mechanisms in toxic acute renal failure. Am J Kidney Dis. 1997;29(3):465–77.
24. Thiele RH, Isbell JM, Rosner MH. AKI associated with cardiac surgery. Clin J Am Soc Nephrol. 2015;10(3):500–14.